Contrast-Enhanced Ultrasonography Features of Breast Malignancies with Different Sizes: Correlation with Prognostic Factors

Zhao, Liang; Liu, Hui; Wei, Qing; Xu, Gelin; Wu, Jian; Xu, Hui‐Xiong; Wu, Rong; Pu, Huan

doi:10.1155/2015/613831

Cited by 38 publications

(14 citation statements)

References 35 publications

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“… 23 It was shown that c-erb-B2 was positive in 50.96% of malignant breast lesions, and the positive expression of this gene was associated with high enhancement in imaging. 24 The defects in vascular perfusion are common in ER-negative tumors. 24 Another study has shown that the concentric mode of enhancement was common in ER-negative tumors, and perfusion defects were generally seen in tumors with negative ER expression, positive c-erb-B2 expression, and positive Ki-67 expression, 25 which were consistent with this study.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic values of contrast-enhanced ultrasound in breast cancer: a retrospective study

Zhao¹,

Liu²,

Hu³

et al. 2017

OTT

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This study aimed to explore the diagnostic and prognostic values of contrast-enhanced ultrasound (CEUS) in breast cancer. Between September 2009 and October 2011, a total of 143 breast cancer patients and 161 healthy people were selected as case group and control group, respectively. After the identification of lesions by conventional ultrasound, all patients underwent CEUS. The CEUS images were analyzed, and time–intensity curves (TICs) were obtained. Hematoxylin–eosin and immunohistochemistry staining was performed on tissue specimens, according to which the expressions of estrogen receptor (ER), c-erb-B2, p53, and Ki-67 were measured. Multivariate logistic regression analysis was used to compare CEUS and TIC parameters between the two groups. Compared with the control group, cancer patients showed high enhancement, heterogeneous enhancement or defects in the central region, expansion of lesion diameter after enhancement and crab-like blur lesion edges. The peak intensity (PI), relative start time of enhancement, relative PI, and relative area under the curve in the case group were significantly higher than those in the control group. Logistic analysis showed that the uniformity of enhancement, expansion of lesion diameter, and relative PI were significant diagnostic parameters of breast cancer, with area under the curve being 0.798, 0.776, and 0.919, respectively. There were strong associations between CEUS characteristics and expressions of prognostic factors in breast cancer: the heterogeneous enhancement was common in c-erb-B2-positive tumors; the centripetal enhancement occurred more in ER-negative tumors; perforator vessels were often seen in tumors at high histological grade; perfusion defects were common in ER-negative, c-erb-B2-positive, and Ki-67-positive tumors. CEUS is a useful tool for the early diagnosis and prognosis of breast cancer.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic values of contrast-enhanced ultrasound in breast cancer: a retrospective study

Zhao¹,

Liu²,

Hu³

et al. 2017

OTT

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“…To illustrate, perfusion defects are the result of rapid growth and active metabolism of malignant tumors, leading to insufficient vascular formation and nutrition supply and finally to central hypoxia and necrosis (38). Moreover, Liu et al attribute perfusion defects to low cellularity, desmoplastic stroma, dilated duct, degeneration, fibrosis or necrosis (18). According to the literature, central necrosis and fibrosis are common in ER negative tumors (39,40), while regional hypoxia is associated with reduced ER expression in breast cancer patients (41).…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies in literature exploring correlation between CEUS characteristics and pathological prognostic factors in breast cancer patients during the last six years, indicating a novel research area (13)(14)(15)(16)(17)(18)(19). Also, these studies have shown mixed results and have had differences in patients' populations, study design, statistical analysis etc.…”

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confidence: 99%

“…Also, these studies have shown mixed results and have had differences in patients' populations, study design, statistical analysis etc. Indicatively, three studies have investigated only qualitative CEUS characteristics' correlation to pathological prognostic factors (14,15,18), two studies have investigated only quantitative CEUS characteristics' (13,16), and only two studies have investigated both quantitative and qualitative CEUS characteristics' (17,19).…”

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confidence: 99%

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Correlation Between Contrast-enhanced Ultrasound Characteristics (Qualitative and Quantitative) and Pathological Prognostic Factors in Breast Cancer

Vraka

Panourgias

Sifakis

et al. 2018

In Vivo

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“…From the gained results it is obvious that smaller lesions could cause diagnostic problem. The problem with small lesions and CEUS examination tried to explain in their study Zhao et al They reported that lesions with different size expressed different CEUS features that are dependent on the neovascularisation [17], and this can cause a diagnostic ambiguity. Small lesions according Zhao (smaller than 20 mm) might have poor neovascularization due to slow growth, low grade or early stage of disease.…”

Section: Discussionmentioning

confidence: 99%

Pitfalls of Contrast Enhanced Ultrasound (CEUS) in determination of breast tumor biological dignity

Lehotská¹,

Rauova²,

Vanovcanova³

2018

neo

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The aim of this prospective study was to identify characteristics of breast lesions on contrast enhanced ultrasound (CEUS) that can be a source of diagnostic ambiguity and cause under- or overestimation of examined breast lesions. 215 women (range 23-76 y., mean age 53.16 y) with 215 breast lesions were examined by B-mode ultrasound, followed by CEUS and core biopsy. CEUS parameters: degree of opacification, character of washout and preliminary CEUS result (suspicious, non-suspicious, uncertain) were subsequently correlated with histopathological outcomes. Observed qualitative variables, CEUS results and their analysis with respect to histological type were evaluated using Pearson χ2 square test, p<0.05 was statistically significant. Differences in mean lesion size, mean age of patients, mean size between groups (malignant/benign) with respect to CEUS result were evaluated by t-test. 215 tumors, 116 (53.93%) benign and 99 (46.05%) malignant lesions. 17 (14.66%) benign and 15 (15.15%) malignant lesions expressed atypical washout, 5 (4.31%) benign lesions had early washout and 38 (38.38%) had continuous washout (p<0.0001). 56 (48.28%) benign and 55 (55.56%) malignant lesions had middle degree of opacification, 19 (16.38%) benign had high and 5 (5.05%) malignant lesions low degree of opacification (p<0.0001). Finally, 38 (32.72%) benign and 20 (20.20%) malignant were marked CEUS uncertain. As risk lesions are considered fibroadenomas, fibrocystic lesions, papillomas and low grade DCIS or invasive breast tumors, especially lesions smaller than 10 mm.Identification of CEUS pitfalls with respect to problematic histopathologic entities can reduce the risk of misdiagnosis and improve further management of breast lesions.

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Contrast-Enhanced Ultrasonography Features of Breast Malignancies with Different Sizes: Correlation with Prognostic Factors

Cited by 38 publications

References 35 publications

Diagnostic and prognostic values of contrast-enhanced ultrasound in breast cancer: a retrospective study

Diagnostic and prognostic values of contrast-enhanced ultrasound in breast cancer: a retrospective study

Correlation Between Contrast-enhanced Ultrasound Characteristics (Qualitative and Quantitative) and Pathological Prognostic Factors in Breast Cancer

Pitfalls of Contrast Enhanced Ultrasound (CEUS) in determination of breast tumor biological dignity

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